title: Peri-operative thoracic epidural analgesia for thoracotomy.
abstract: In a prospective study, experiences with peri-operative thoracic epidural analgesia (TEA) for thoracic surgery were documented. Two hundred and seven patients scheduled for elective thoracotomy were investigated. All patients received thoracic epidural catheters 2 h pre-operatively. The catheters were inserted between T4-5 and T8-9 intervertebral spaces. Epidural medication with bupivacaine and fentanyl was started preoperatively, maintained throughout surgery and was continued post-operatively via patient controlled analgesia (PCA) devices. Patients were anaesthetized with propofol and tracheal intubation was performed following neuromuscular blockade with vecuronium. Ninety-five percent of the patients were extubated immediately after surgery. 70.5% of all the patients had excellent post-operative analgesia (VAS pain scoring 0-2) on the day of surgery, 78% the day after surgery and 91% on the second day after surgery. Additionally early post-operative mobilization could be started in 63% of all patients. No neurological sequelae caused by thoracic epidural catheterization was seen in the early post-operative period.
authors.affiliation: Department of Anaesthesiology and General Intensive Care, University of Vienna, Allgemeines Krankenhaus, Vienna, Austria.
authors.forename: A M
authors.initials: AM
authors.lastname: Schultz
authors.forename: A
authors.initials: A
authors.lastname: Werba
authors.forename: S
authors.initials: S
authors.lastname: Ulbing
authors.forename: G
authors.initials: G
authors.lastname: Gollmann
authors.forename: F
authors.initials: F
authors.lastname: Lehofer
mesh_terms: D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002045:Bupivacaine; D005260:Female; D005283:Fentanyl; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies; D013908:Thoracotomy
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine